- Distal radius fracture
- Ulnar styloid fracture
- Scaphoid fracture
- Carpal-metacarpal dislocation
- Osteomyelitis distal radius
The x-ray reveals a fracture of the ulnar styloid, as evidenced by a break in the cortex, displacement of the fracture fragment, and a loss of alignment of the trabeculations.
Learnings/What to Look For
- Approximately 50% of distal radial fractures will have associated ulnar styloid fracture.
- Ulnar styloid fractures can also occur as isolated injuries, as in this case.
- Most fractures are small avulsions at the tip, though occasionally involving the body or base of the styloid.
- Fractures through the base of the styloid can lead to instability of the distal radioulnar joint and injury to the triangular fibrocartilage complex.
- Accessory ossicles can appear similar to styloid avulsions.
Pearls for Initial Management and Considerations for Transfer
- With evidence of an isolated ulnar styloid fracture, search for a distal radius fracture or a carpal fracture or dislocation.
- If the neurovascular status is intact, the patient may be placed in an ulnar gutter or volar splint with recommendations.
- Indications for transfer include intractable pain, consideration of vascular injury, compartment syndrome, or associated displaced fracture or dislocation.
Acknowledgment: Image courtesy of Teleradiology Specialists.